November 10th, 2009 – By a vote of 220 to 215, House Speaker Nancy Pelosi narrowly won approval for House Bill HR 3962, the Affordable Health Care for America Act.
The House Democrats needed 218 votes to pass their bill and won by such a narrow margin due to detractors within their own party and near unanimous opposition by Republicans. The narrow victory was troubling as while Democrats enjoy an overwhelming majority in the House, they will have their work cut out for them in the Senate.
The Senate should begin work on their bill in the coming weeks. If the Senate passes its bill, the House and Senate bills would have to be reconciled into one document and voted on again.
The Republican National Committee released a statement that reads, “Today, President Obama and Nancy Pelosi finally got what they have been creating behind closed doors these past months — a government-run health care experiment that will increase families’ health care costs, increase the deficit, increase taxes on small businesses and the middle class, and cut Medicare.”
Interestingly, there are many Democrats that agree with this opinion. The White House is facing a growing revolt from some Democrats who say the bills Congress is considering do not fulfill President Obama’s promise to slow the runaway rise in health care spending.
Experts, including some of those who consulted with the White House, (like Dr. Denis A. Cortese, chief executive of the Mayo Clinic) say the measures take only baby steps toward revamping the current fee-for-service system, which drives up costs by paying health providers for each visit or procedure performed.
The House and the Senate both propose some limited cost-saving measures. The House bill projects $440 billion in Medicare savings over 10 years; the Senate Finance Committee bill projects about $420 billion. White House officials say there will be additional, substantial savings in the private sector, as well. But how much is not clear.
Dr. Cortese, of the Mayo Clinic, said the bills could do more to reward quality care over quantity. He said he had met with Mr. Orszag and others at the White House and had proposed legislative language that would give Medicare three years to begin rewarding hospitals that are delivering better care at lower cost.
“Our position has been focusing on paying for value,” he said, adding, “My take is there are people in the White House who understand exactly what I’m saying.”
Yet a deal the White House made with the hospital industry could make it difficult to cut costs too deeply.
The White House and the Senate Finance Committee chairman, Max Baucus of Montana, agreed to limit hospitals’ payment reductions to $155 billion over 10 years. Those savings will come almost exclusively from “an agreement to squeeze the prices a little bit across the board, rather than reforming the way payments work,” said Mark McClellan, who ran Medicare under President George W. Bush.
Let us not forget that rising health care costs is the number one reason why we have so many uninsured Americans and why we have increasing difficulty paying ever increasing health insurance premiums. For Health reform to succeed, it must address the underlying cost drivers that cause health insurance to be so expensive.
Source: New York Times article by Sheryl Gay Stolberg